The Significance of Orbital Preservation in Surgery of the Sinonasal Malignancies

Abstract

Background and Objectives：Preservation of orbital contents during surgery of paranasal sinus malignant tumors encroaching on the orbit remains a controversial issue. The purpose of this study is to investigate significance of orbital preservation in the surgery of sinonasal malignancies abutted orbit in view of oncological safety and functional outcome. Subjects and Method： A retrospective review was conducted using medical records of 41 patients who underwent surgery between Mar 1991 and Feb 2006 for sinonasal malignancies abutting or eroding orbit. Results：Among 41 cases of sinonasal tract malignancies abutting or invading into the orbit, thirty-four of 41 tumors were amenable for surgical treatment with orbital preservation and the remaining 7 underwent orbital exenteration. 71.4% (5/7) of the patients whose orbit was exenterated had local recurrence, compared with 20.5% (7/34) of the patients whose orbit was preserved. The 5-year survival rate was 50.0% in the orbit exenterated group and 59.9% in the orbit preserved group. This difference was not statistically significant (p>0.05). In the preservation group, local recurrence rate was 27.1% (2/9) in the periorbita involvement group, 22.2% (2/9) in the bony destruction group and 14.3% (2/14) in the abutting orbit group. There is no statistically significant difference among three groups. Although some patients had problems, the fact that all patients retained their orbit demonstrates adequate visual acuity. Conclusion：Local recurrence and survival rate were not significantly different between the orbital preservation and exenteration group and also between the bony destruction and periorbita involvement group. So, in the selected case of periorbita invasion, orbital preservation could be considered.